Bowel Obstruction due to a Gallstone in the Second Portion of the Duodenum—A Case Report—

Abstract

A 93-year-old woman was admitted to the hospital because of vomiting. Abdominal computed tomography showed a cholecystoduodenal fistula and a 55-mm gallstone in the second portion of the duodenum. Upper gastrointestinal endoscopy showed the impacted gallstone in the second portion of the duodenum, but its endoscopic extraction was unsuccessful. Five days after admission, surgery was performed. An attempt was made to move the impacted gallstone in the second portion of the duodenum to the distal side, but it only moved to the third portion. Finally, the gallstone was removed by opening the wall of the third portion of the duodenum, Primary closure was performed with gastrojejunostomy for decompression. A case of bowel obstruction in the duodenum due to a gallstone is relatively rare, and the treatment strategy for them has not been established. Gallstone ileus most often occurs in elderly patients ; therefore, in the case of obstruction of the duodenum by gallstone, it is necessary to determine the treatment strategy for each case based on each patient's general condition, comorbid diseases, and impacted site.